Non-Alcoholic Steatohepatitis (NASH)
Progressive form of NAFLD characterized by hepatic steatosis with lobular inflammation and hepatocyte ballooning, with or without fibrosis, capable of progressing to cirrhosis and hepatocellular carcinoma.
Also: MASH, Metabolic dysfunction-associated steatohepatitis, NASH
NASH diagnosis requires liver biopsy or validated non-invasive markers (FibroScan, MR elastography, FIB-4 score). Pathogenesis involves a "two-hit" or multiple-hit model: hepatic fat accumulation plus oxidative stress, lipotoxicity, gut-derived endotoxin, and altered bile acid signaling. Resmetirom (THR-β agonist) became the first FDA-approved NASH therapeutic; weight loss and pioglitazone remain key adjuncts.
How one textbook covers it
Modern Nutrition in Health and Disease, 12th ed. — Ch 85: Liver Disease
NASH diagnosis requires liver biopsy or validated non-invasive markers (FibroScan, MR elastography, FIB-4 score). Pathogenesis involves a "two-hit" or multiple-hit model: hepatic fat accumulation plus oxidative stress, lipotoxicity, gut-derived endotoxin, and altered bile acid signaling. Resmetirom (THR-β agonist) became the first FDA-approved NASH therapeutic; weight loss and pioglitazone remain key adjuncts.
Related terms
Cirrhosis, Insulin resistance, NAFLD